JP2020524016A - Vitrectomy probe - Google Patents

Abstract

In some embodiments, the vitrectomy probe can include an inner cutting tube that reciprocates within the outer tube. The outer tube includes side ports and the inner tube includes a distal cutting port and, in some embodiments, additional side ports. In some embodiments, the inner tube can also include an upper flat edge that cuts across the outer tube side port. In some embodiments, the diaphragm may drive the inner tube and have an open stroke side of lower hardness material than the closed stroke side. In some embodiments, the suction tube coupled to the vitrectomy probe can include a first suction tube and a second suction tube that is less rigid than the first suction tube. In some embodiments, the vitrectomy probe can be coupled to a pneumatic tube that is stepped or tapered.

Description

Microsurgery often requires accurate cutting and/or removal of various living tissues. For example, some ophthalmic surgeries may require cutting and removing multiple portions of the vitreous humor, a transparent jelly-like substance that fills the posterior segment of the eye. The vitreous humor, or vitreous, is made up of a large number of microscopic fibrils, often attached to the retina. Therefore, cutting and removal of the vitreous is meticulous to avoid retinal traction, detachment of the retina from the choroid, retinal tear, or, in the worst case, cutting and removal of the retina itself. Must be done with care. In particular, it requires careful attention such as management of movable tissues (for example, cutting and removal of the vitreous body near the detached part of the retina or the retinal tear), incision of the vitreous base, and cutting and removal of the membrane. The work is particularly difficult.

A microsurgical cutting probe used in posterior segment ophthalmic surgery includes a hollow outer cutting member, and a hollow inner member coaxially arranged with the hollow outer cutting member and movably arranged therein. A cutting member, a port extending radially through the outer cutting member near the distal end of the outer cutting member, and a radius extending through the inner cutting member near the distal end of the inner cutting member. A port extending in a direction. Vitreous humor and/or membranes can be aspirated to the open port of the outer cutting member and the inner member can be actuated to extend the inner cutting member in the distal direction. When the inner cutting member extends in the distal direction, the cutting surfaces of both the inner and outer cutting members cooperate to cut the vitreous and/or the membrane, after which the cut tissue is removed from the inner cutting member. Is sucked through. The vitreous and/or membrane can then be aspirated into the open ports of both the outer and inner cutting members, and the inner member can be actuated to retract the inner cutting member proximally. The inner and outer cutting members cooperate to again cut the vitreous and/or membrane and aspirate the cut tissue.

The distance between the distal end of the outer cutting member and the closest cutting edge of the outer port is called the port to tip distance (PTTD). The PTTD may depend on the overall travel of the inner cutting member, the thickness of the outer cutting member cap (at the distal end of the outer cutting member), and the clearance required between the inner cutting member and the cap. .. The PTTD of a typical vitrectomy cutter is in the range of 0.009 to 0.025 inches for a flat end vitrectomy probe.

In various embodiments, a vitrectomy probe can include an outer cutting tube with an outer port side opening and an inner cutting tube positioned within the outer cutting tube. The inner cutting tube may have an open distal end with a cutting edge. The vitrectomy probe may further include a diaphragm (located within the drive chamber) coupled to the inner cutting tube. The diaphragm can move back and forth in the drive chamber when alternating air supply (via air drive lines) and venting on either side of the diaphragm. Therefore, the movement of the diaphragm causes the open distal end of the inner cutting tube to move back and forth across the outer port side opening to cut the tissue contained in the outer port side opening. Oscillation may occur within the outer cutting tube of the tube. The inner cutting tube also includes a top flat perpendicular to the inner tube longitudinal axis (ie, for example, in the range of about 70 to 110 degrees) at the portion of the inner cutting tube that cuts across the outer port side opening. It may have edges. The diaphragm includes an open stroke side surface having a first contact surface for contacting the inner wall of the drive chamber when the inner cutting tube is in the retracted position, and an opposing drive chamber when the inner cutting tube is in the extended position. A closed stroke side surface with a second contact surface for contacting the wall. The first contact surface may have a lower hardness material (eg, silicone or similar material) than the second contact surface (eg, may include polycarbonate, polysulfone, or similar material).

In some embodiments, an air drive line may couple the vitrectomy probe to the surgical console to deliver air from the surgical console to the probe drive chamber. In some embodiments, the air drive line may include internal holes of non-uniform cross section along the length of the air drive line. The air drive line may have a first segment and a second segment (the first segment defines a first passage having a first diameter, and the second segment has a second diameter). Defining a second passage having a). The first diameter can be different than the second diameter.

In some embodiments, the inner cutting tube can have a distal side port with a distal side port cutting edge. When the inner cutting tube is retracted into the outer cutting tube, the tissue contained in the outer port side opening also enters the distal side port of the inner cutting tube and when the inner cutting tube is retracted into the outer cutting tube, the distal Allows to be cut by the side port cutting edge.

In some embodiments, a suction tube is coupled to the inner cutting tube to create a vacuum on the inner cutting tube. The suction tube can include a first suction tube and a second suction tube coupled to the first suction tube. The second suction tube may be coupled at the distal end to the vitrectomy probe and at the proximal end to the first suction tube. In some embodiments, the second suction tube may be less stiff than the first suction tube and shorter than the first suction tube.

The accompanying drawings illustrate embodiments of the devices and methods disclosed herein and, together with the description, serve to explain the principles of the disclosure.

FIG. 1 is a diagram of an exemplary surgical system consistent with one aspect of the disclosure, consistent with the principles and teachings described herein. 2 is a block diagram of aspects of the exemplary surgical system of FIG. 1, according to embodiments. FIG. 1 is a cross-sectional view of an exemplary vitrectomy probe operable in accordance with the principles and teachings described herein. 9A-9C show various vitrectomy probe distal end configurations, according to various embodiments. 3 illustrates a diaphragm and drive shaft according to an embodiment. 6 illustrates opposite sides of a diaphragm, according to an embodiment. 6A illustrates a cross section of a diaphragm chamber within a vitrectomy probe, according to an embodiment. 6 illustrates a bend of an inner cutting tube according to an embodiment. 3 illustrates a reinforcement for an outer cut tube according to an embodiment. 6 illustrates a tube segment coupling a probe to a surgical console, according to an embodiment. 2A illustrates a cross section of a pneumatic and suction tube segment according to an embodiment. 6 illustrates a vitrectomy probe distal end according to various embodiments. 6 illustrates measurements of an outer cutting tube of a vitrectomy probe according to various embodiments. 6 shows measured values of an outer cutting tube and an inner cutting tube of a vitrectomy probe according to an embodiment. 6 shows measurements of outer and inner cutting tubes of a vitrectomy probe according to an embodiment of an inner tube having a flat edge feature. 5A-5C show configurations of outer and inner cutting tubes of a vitrectomy probe according to various embodiments. FIG. 3 is a partial cross-sectional view of a stepped air drive line usable with the surgical system shown in FIG. 2, according to an embodiment. FIG. 18 is a partial cross-sectional view of a sleeve coupling the stepped air drive line shown in FIG. 17, according to an embodiment. 6 illustrates a flowchart of a method of operating a vitrectomy probe, according to an embodiment.

It should be understood that both the above summary and the following detailed description are merely exemplary and explanatory and provide a further description of the principles of the present disclosure.

FIG. 1 illustrates a vitrectomy surgery system console (generally designated 100) according to an exemplary embodiment. The surgical console 100 may include a base housing 102 and an associated display screen 104 that presents data regarding the operation and performance of the system during a vitrectomy surgery. In embodiments, the base housing 102 may be moveable, including wheels, for example to facilitate movement, if desired. In alternative embodiments, the base housing 102 may not include wheels. Surgical console 100 may include a vitrectomy probe system 110 that includes a vitrectomy probe 112, as described in more detail below with reference to subsequent figures.

FIG. 2 shows a schematic diagram of exemplary components of a vitrectomy probe system 110 according to an embodiment. The probe system 110 may include a vitrectomy probe 112, a pneumatic source 120, a probe driver shown as an adjustable, on-off air driver 122, a muffler 124, and a controller 126. In embodiments, controller 126 may be a processor that includes one or more processing cores capable of performing parallel or sequential operations. Alternatively, controller 126 may be dedicated hardware, such as an application specific integrated circuit (ASIC), to name just a few. Source 120, driver 122, muffler 124, and probe 112 may be in fluid communication with each other along a line that represents a flow path or streamline. The controller 126 may be in electrical communication with the driver 122. In embodiments, the controller 126 may control the operation of both the driver 122 and various aspects of the probe 112, including the vibration frequency by the actuator and the flow rate of fluid to the surgical site.

FIG. 3 shows a partial cross-sectional view of an exemplary vitrectomy probe, such as the vitrectomy probe 112 introduced in FIGS. In this example, vitrectomy probe 112 may be an air driven probe that operates by alternately receiving air pressure through first and second ports 140 and 142. The probe 112 has, as its basic components, a cutter 150, an outer cutting tube 152 (also known as a needle), an inner cutting tube 154 shown in non-sectional side view, and here. May include a probe actuator or motor, shown as a reciprocating air driven diaphragm 156, all at least partially enclosed by a housing 158 within a sealed drive chamber 175. The housing 158 may include a distal end 160 at the probe proximal end, with first and second air supply ports 140, 142 and one suction port 162 to provide suction of material from the cutter 150.

In embodiments, the air driver 122 (FIG. 2) of the vitrectomy probe system may be a standard four way on/off valve. The air driver 122 may have a solenoid that operates to move the driver to one of the two on/off positions shown in the example of FIG. Here, the air driver 122 may be in a position to provide air pressure to the first port 140 (FIG. 3) and vent air pressure from the second port 142 (FIG. 3). In this position, air pressure may travel from the pressure source 120 through the on-off air driver 122 to the first port 140, where the air pressure provides air power to the vitrectomy probe 112. At the same time, the air pressure at the second port 142 may travel through the on/off air driver 122 to the muffler 124, where it is exhausted to, for example, the atmosphere. In other positions, the on-off air driver 122 may allow air pressure to move from the pressure source 120 to the second port 142, where air pressure provides air power to the vitrectomy probe 112. At the same time, the air pressure in the first port 140 may vent through the on-off air driver 122 to the muffler 124, where it is vented to the atmosphere. The on-off air driver may be configured to receive an operating signal from controller 126.

During operation, air pressure may be directed from the source 120 to the first and second ports 140, 142 to operate the vitrectomy probe 112. The on-off air driver 122 may alternate at its very high speed between its two positions to alternately provide air pressure to the first and second ports 140, 142. Although shown with a single air driver 122, other embodiments include two air drivers, one of which is associated with each of the two ports 140, 142. These embodiments may operate in a manner similar to that described, with the driver configured to independently receive the motion signal from the controller 126 (FIG. 2). Still other arrangements are considered.

Returning to FIG. 3, the cutter 150 may include a distal end 166 extending from the housing 158 and shown in more detail below in FIG. 4a. The outer cutting tube 152 and the inner cutting tube 154 may both be cylindrical tubes with hollow holes. As shown in FIGS. 4a-b, the distal end of outer cutting tube 152 (needle cap 173) may include a beveled (ie, angled) end. In some embodiments, the outer cutting tube distal end (needle cap 173) may be flat. The distal end of outer cutting tube 152 may be closed using, for example, spin closed machining, adhesives, welding (eg, laser welding), or the like. For example, the beveled end can be closed by laser welding a pieced over the angled end. In some embodiments, the inner cutting tube 154 can further have an open end, such as shown as the distal port 170 in Figures 4a-b.

In general, inner cutting tube 154 may oscillate within outer cutting tube 152 in response to a probe actuator. In an embodiment, the inner cutting tube 154 may be driven by pneumatic pressure distributed on opposite sides of the diaphragm 156. In one example operation, if air pressure increases at the first port 140, the diaphragm 156 moves distally, displacing the inner cutting tube 154 relative to the outer cutting tube 152, thereby causing the inner cutting tube 154 to move. The first cutting edge 157 at the distal end may be moved distally to cut tissue. This may cut any vitreous material that has been sucked into the tissue receiving outer port 168 of the outer cutting tube 152. In some embodiments, the first cutting edge 157 can be formed at the flared distal end of the inner cutting tube 154 (as shown in Figures 4a-b). In some embodiments, the distal end of inner cutting tube 154 may not be flared. The vitreous may be aspirated through the distal opening 170 of the inner cutting tube 154. In some embodiments, the vitreous can also be aspirated through the distal port 172 on the side of the inner cutting tube 154b. "154a" used in the drawings to show the inner cutting tube without lateral distal port 172, and "154b" ("154a") used in the drawings to show the inner cutting tube with lateral distal port 172. And "154b" are collectively referred to in the drawings and herein as "154" when the specified details apply to both "154a" and "154b"). By venting the pressure at the first port 140 and increasing the pressure at the second port 142, the diaphragm 156 is moved in the proximal direction, proximate the distal end of the inner cutting tube 154b and in the proximal direction. The second cutting edge 151 facing to the proximal direction to move the outer port 168 of the outer cutting tube 152 and the side distal port 172 of the inner cutting tube 154b when they are at least partially aligned. Cleave any vitreous material that may be present.

FIG. 5 illustrates diaphragm 156 and drive shaft 174, according to one embodiment. The diaphragm 156 has an open stroke side surface 176 (ie, a proximal closed drive chamber wall 181 (see FIG. 7) when the inner cutting tube 154 is in the retracted (most proximal) position relative to the outer cutting tube 152). The side of the diaphragm 156 that contacts). The diaphragm 156 also contacts the closed stroke side wall 178 (ie, the diaphragm 156 that contacts the distal closure drive chamber wall 182 when the inner cutting tube 154 is in the extended (distal-most) position relative to the outer cutting tube 152). Side of).

As shown in FIGS. 6 a-b, in some embodiments, the diaphragm 156 has a first contact surface (eg, a proximal stop 179) and a second contact surface (eg, a proximal stop 179) on opposite sides of the diaphragm 156. For example, it may include a distal stop 180). In some embodiments, the proximal/distal stops 179/180 may contact their respective drive chamber walls 181/182. For example, the proximal stop 179 may contact the proximal closure drive chamber wall 181 when the inner cutting tube 154 is in the retracted/most proximal position. The distal stop 180 may contact the distal closure drive chamber wall 182 when the inner cutting tube 154 is in the extended/distalmost position. Stops 179/180 may be made of a hard material (eg, polycarbonate, polysulfone, or similar material) or a relatively soft material (eg, silicone or similar material). In some embodiments, the stops 179/180 can be made of the same material. In some embodiments, the stops may be made of different materials. For example, the proximal stop 179 may be made of a soft material (eg, silicone or similar material) and the distal stop 180 may be made of a rigid material (eg, polycarbonate, polysulfone, or similar material). .. In another embodiment, the proximal stop 179 is made of a rigid material (eg, polycarbonate, polysulfone, or similar material) and the distal stop 180 is made of a soft material (eg, silicone or similar material). May be done. In some embodiments, softer materials may reduce noise from the impact of the contact surface of diaphragm 156 against chamber walls 181/182. Rigid material may be used to provide a more consistent stop (eg, distal stop 180 ensures that inner cutting tube 154 stops before the distal end of outer cutting tube 152). By making a proximal stop of a relatively soft material and a distal stop of a hard material, the probe has a quieter operation, and an inner cutting tube and an outer A reliable stop distance can be maintained with the cutting tube.

Although three distal stops 180 are shown, other numbers of stops may be used (e.g., one stop or more, e.g., ten stops distributed on the contact surface). ) (And more stops may be used). Although the distal stop 180 is shown as oval, other shapes of stop 180 are possible (eg, rectangular). Although three proximal stops 179 are shown, other numbers of stops may be used (e.g., one stop or more, e.g., ten stops distributed on the contact surface). ) (And more stops may be used). Although the proximal stop 179 is shown as three arcuate segments of a circular ridge on the diaphragm 156, other shapes of stop 179 are possible (eg, rectangular). In some embodiments, diaphragm 156 can be made of the same material as one or more of stops 179/180. For example, the distal stop 180 may be an extension of the diaphragm material, while the proximal stop 179 is adhesively attached to the material bonded to the diaphragm (eg, overmolded on the diaphragm 156). Or snap-fitted silicone or the like). As shown in FIG. 7, in some embodiments, the proximal stop 179 can be an extension of diaphragm material, while the distal stop 180 can include material bonded to the diaphragm 156. For example, the diaphragm 156 may be made of a silicone material with a proximal stop formed therein and a rigid distal stop bonded to the diaphragm 156 (eg, overmolded with silicone (or rigid distal). Overmolded on the stop), attached to the silicone with an adhesive, snap-fitted, etc.). As shown in FIG. 7, the distal stop 180 and the central receiving portion 183 (which receives the drive shaft 174) can be made of a rigid material (such as polycarbonate, polysulfone, or similar material) and the diaphragm 156 (eg, Silicone or similar material) may include a silicone portion for the proximal stop 179, which is molded into a rigid material to form an integral piece. The circular recess shown near the proximal stop 179 may be used as part of the molding process. In some embodiments, the proximal stop 179 may be a continuous circular ridge on the diaphragm 156.

FIG. 8 illustrates bending of the inner cutting tube 154 according to an embodiment. In some embodiments, the inner cutting tube 154 has a slight bend to bias the first cutting edge 157 relative to the inner wall of the outer cutting tube 152 to provide a cutting action in the vitreous that enters the port 168. Can be guaranteed. In some embodiments, the angle may vary according to the size of the outer cutting tube 152. For example, for a 23 gauge outer cutting tube 152, the bend length (B) (ie, the distance from the distal end of the inner cutting tube 154 to the bend) is approximately 0.110 inches, and the bend angle (C) is approximately. It can be 3.5 degrees. Other bend angles (C) and bend lengths (B) are also considered for a 23 gauge outer cut tube (eg, bend angle (C) is in the range of approximately 2.0 degrees to 5.0 degrees, or In the range of approximately 3.0 to 4.0 degrees, and the bend length (B) is in the range of approximately 0.065 to 0.15 inches, or in the range of approximately 0.1 to 0.13 inches). .. As another example, a 25 gauge outer cutting tube 152 may have a bend length (B) of approximately 0.060 inches and a bend angle (C) of approximately 4.7 degrees. For 25 gauge outer cutting tubes, other bend angles (C) and bend lengths (B) are also considered (eg, bend angle (C) is in the range of approximately 2.8 degrees to 6.5 degrees, or Approximately 4.0 to 5.5 degrees, and the bend length (B) is approximately 0.035 to 0.15 inches, or approximately 0.05 to 0.07 inches). .. As a further example, a 27 gauge outer cutting tube 152 may have a bend length (B) of approximately 0.050 inches and a bend angle (C) of approximately 4.3 degrees. For 27 gauge outer cutting tubes, other bend angles (C) and bend lengths (B) are also considered (eg, bend angle (C) ranges from approximately 2.6 degrees to 6.0 degrees, or Approximately 3.7 to 4.9 degrees, and the bend length (B) is approximately 0.03 to 0.07 inches, or approximately 0.04 to 0.06 inches) .. As another example, for a dual port probe (see, eg, FIG. 4b), the bend angle (C) may be approximately 3.2 degrees and the bend length (B) may be approximately 0.050 inches. Other bend angles (C) and bend lengths (B) are also considered in the dual port probe (eg, bend angle (C) ranges from approximately 1.9 degrees to 4.5 degrees, or approximately 2. degrees). 7 to 3.7 degrees, and the bend length (B) is in the range of approximately 0.03 to 0.07 inches, or in the range of approximately 0.04 to 0.06 inches).

Although exemplary dimensions/measurements and dimension/measurement ranges are provided throughout this application, these dimensions/measurements are not limiting as they merely present a set of possible dimensions/measurements. Should not be regarded. Other dimensions/measurements are also considered.

As shown in FIG. 9, the outer cutting tube 152 may be supported by a stiffener 200 that extends around the base of the outer cutting tube 152 in the probe body. In some embodiments, the probe may not include the stiffener 200. The outer cutting tube length (L) from the probe body to the distal end may vary according to the size of the outer cutting tube 152. For example, for a 23 or 25 gauge outer cutting tube 152, the length (L) may be approximately 1.25 inches. Other lengths (L) are also considered (eg, for 23 or 25 gauge outer cutting tubes, the length (L) is in the range of approximately 0.75 to 1.75 inches, or approximately 1.1 to 1). It could be in the .4 inch range). The 23 and 25 gauge outer cut tubes may not include the stiffener 200 (or they may include the stiffener 200). In a 25 gauge outer cutting tube length embodiment with stiffener 200, the length (L) may be approximately 1.063 inches. Other lengths (L) are also considered (eg, for a 25 gauge outer cut tube with stiffeners, the length (L) is in the range of approximately 0.65 to 1.5 inches, or approximately 0.9. ~1.2 inches). As a further example, for a 27 gauge outer cutting tube 152 with stiffener 200, the length (L) may be approximately 1.023 inches. Other lengths (L) are also considered (eg, for a 27 gauge outer cut tube with stiffeners, the length (L) is in the range of approximately 0.6 to 1.4 inches, or approximately 0.85. ~1.2 inches). Other lengths (L) are possible. For example, for all gauges with or without reinforcement, the length (L) may be in the range of approximately 0.1 to 3 inches.

FIG. 10 illustrates a tube segment coupling probe 112 to surgical console 100, according to an embodiment. As shown in FIG. 10, in some embodiments, the probe 112 may be coupled to the surgical console 100 by three lines (aspiration tube 1001 and two pneumatic tubes 1002a-b). Pneumatic tubes 1002a-b may include plastic tubes extending from console 100. In some embodiments, the pneumatic tubes 1002a-b may have a hardness in the range of approximately 50-120 Shore A hardness (eg, 80 Shore A hardness). Other hardnesses are also considered. In some embodiments, each pneumatic tube 1002a-b can have a length TL of 84 inches. Other lengths are also contemplated (eg, length TL may be in the range of approximately 50-120 inches, or in the range of approximately 70-100 inches).

In some embodiments, the suction tube 1001 can have more than one tube segment 1011a-b. The suction tube segments 1011a-b can be coupled together by a tube connector 1007. The connector 1007 may connect each tube segment by a friction fit (eg, the ends of the tube segments 1011a-b slide over the respective male receiving connector segments, and the inner surface of the tube and the male connector segments). Remains fixed by the friction between). Other attachments are also contemplated (eg, adhesive, crimp, etc.). In some embodiments, the tube segments 1011a-b can be a single continuous tube with the property of gradual transition at a point along the tube or along at least a portion of the tube. In some embodiments, the suction tube segments 1011a-b can have different lengths. For example, the tube segment 1011a from the console 100 to the connector 1007 is substantially longer than the tube segment 1011b from the handpiece 112. As an example of the relative length, the length of suction tube segment 1011a from console 100 to connector 1007 can be approximately 79 inches, and the length SL of suction tube segment 1011b from connector 1007 to handpiece 112 is approximately 5 inches. Can be Other lengths are also considered. For example, the length of the suction tube segment 1011a from the connector 1007 to the console 100 may be in the range of approximately 45-110 inches, or in the range of approximately 65-95 inches. The length SL of the suction tube segment 1011b from the connector 1007 to the handpiece 112 may be in the range of approximately 3-7 inches, or approximately 4-6 inches. In some embodiments, the suction tube segments 1011a-b can have different hardness. For example, the longer suction tube segment 1011a from the console 100 to the connector 1007 may have a higher hardness than the shorter suction tube segment 1011b from the connector 1007 to the handpiece. For example, in one embodiment, the longer suction tube segment 1011a may have a hardness of approximately 80 Shore A hardness and the shorter suction tube segment 1011b may have a hardness of approximately 40 Shore A hardness. Other hardnesses are also considered. For example, the hardness of the longer suction tube segment 1011a may be in the range of approximately 50-115 Shore A hardness, or in the range of approximately 70-95 Shore A hardness. The hardness of the shorter suction tube segment 1011b may be in the range of approximately 25-55 Shore A hardness, or approximately 35-45 Shore A hardness. In some embodiments, shorter, lower hardness suction tube segments may also make the handpiece 112 more manageable by the surgeon (vs. a handpiece joined by a higher hardness tube). Lower hardness tubes may be more flexible than higher hardness tubes.

As shown in FIG. 11, the pneumatic tubes 1002a-b and the suction tube 1001 may be coupled through at least a portion of their length. For example, the tubes can be joined by being co-extruded or by an adhesive along the length of the tubes that holds them. In some embodiments, as shown in FIG. 11, the angle α between the center points of the combined pneumatic tubes 1002a-b can be approximately 90 degrees. Other values of α are also contemplated (eg, in the range of approximately 55 degrees to 125 degrees, or in the range of approximately 75 to 100 degrees). In some embodiments, as shown in FIG. 11, the angle β between the center points of the combined pneumatic tubes 1002a-b and suction tube 1001 can be approximately 75 degrees. Other values of β are also considered (eg, in the range of approximately 45 degrees to 105 degrees, or in the range of approximately 65 degrees to 85 degrees). In some embodiments, insufflation tubes 1002a-b and suction tube 1001 may not be joined along their length.

In some embodiments, the pneumatic tubes 1002a-b and the suction tube 1001 may have an indicator on the tube to indicate the tube type. For example, striped patterns 1005a-b may be included along at least a portion of the tube length. In some embodiments, the blue striped pattern 1005a may display the suction tube 1001. The black striped pattern 1005b may be used to display the first pneumatic tube 1002a, and the gray striped pattern 1005c may be used to display the second pneumatic tube 1002b. In some embodiments, the stripes may have a width SW of approximately 0.060 inches. Other widths SW are also contemplated (eg, in the range of approximately 0.035 to 0.085 inches, or in the range of approximately 0.05 to 0.07 inches). Other indicators are also considered.

Further, as shown in FIG. 11, the inner diameter ΦPD of the pneumatic tubes 1002a-b may be approximately 0.075 inches. Other diameters are also contemplated (eg, in the range of approximately 0.045 to 0.10 inches, or in the range of approximately 0.065 to 0.085 inches). In some embodiments, the inner diameter ΦAD of the suction tube 1001 can be approximately 0.06 inches. Other diameters are also contemplated (eg, in the range of approximately 0.035 to 0.085 inches, or in the range of approximately 0.05 to 0.07 inches). In some embodiments, the pneumatic tubes 1002a-b and the suction tube 1001 can all have the same outer diameter ΦOD of approximately 0.125 inches. Other outer diameters ΦOD are also contemplated (eg, in the range of approximately 0.075 to 0.18 inches, or in the range of approximately 0.10 to 0.15 inches). In some embodiments, insufflation tube 1002a-b or suction tube 1001 may have a different diameter than the other insufflation tube 1002a-b or suction tube 1001.

12a-c show a vitrectomy probe distal end according to various embodiments. Figure 12a shows a cross section of the eye with a vitrectomy probe. FIG. 12b shows a close-up view of the distal flat tip vitrectomy probe near the retina (eg, at the port edge tip to retina (PTRD) distance X from the retina). PTRD is the shortest distance between the port edge and the retina. As shown in FIG. 12c, the user positions the port (eg, PTRD distance Y, where Y<X) near the retina of the eye when the distal end of the vitrectomy probe is beveled. obtain. For example, X may be 0.018 inches while Y may be 0.008 inches. Other X and Y values are also considered. When using a vitrectomy probe, the user may want to remove the vitreous as close to the retina as possible without cutting the retina itself. The beveled tip may allow for tissue/membrane ablation or incision near the retina. The beveled tip also allows the user to lift or pick up the membrane without having to switch to another instrument.

13a-b show some measurements of the outer cutting tube 152 of a vitrectomy probe according to various embodiments. As shown in FIG. 13a, in some embodiments of the flat tip (here, from the distal end face of the outer cutting tube 152 to the extended rear surface line 190 of the outer cutting tube facing the outer port side opening). Angle Q1 is 90 degrees), and the port edge to distal probe tip (PTTD) measurement F1 may be approximately 0.009 inches for 23, 25, and 27 gauge probes. Other PTTD measurements F1 are also considered. For example, the PTTD measurement F1 may range from approximately 0.003 to 0.015 inches, approximately 0.003 to 0.0085 inches, approximately 0.005 to 0.025 inches, or approximately 0.008. It may be in the range of 0.010 inches. In some embodiments, the PTTD measurement F1 is determined by how far the inner cutting tube 154 travels during the entire travel of the inner cutting tube 154 (ie, while the most distal portion of the inner cutting tube 154 moves). 152), the thickness of the needle cap 173, and the clearance between the inner cutting tube 154 and the cap 173 (ie, the most distal end of the inner cutting tube 154 and the outer cutting tube 152). Distance to the cap 173 on the inside and at the most distal point of travel of the tar tube). In some embodiments, the port edge tip to retina distance (PTRD) F2 for the flat tip is approximately 0.021 inches for a 23 gauge probe, approximately 0.018 inches for a 25 gauge probe, and 27 gauge. Can be approximately 0.016 inches. Other PTRD distances F2 for flat tips are also considered (for example, F2 may be in the range of approximately 0.01-0.03 inches for various gauge probes). As shown in FIG. 13b, in some embodiments of the beveled tip, the PTRD at the beveled tip B2 (extending the outer cutting tube from the distal end face of the outer cutting tube 152 opposite the outer port side opening). The angle Q2 to the back line 190 is approximately 60 degrees), is approximately 0.009 inches for a 23 gauge probe, approximately 0.008 inches for a 25 gauge probe, and approximately 0.007 inches for a 27 gauge probe. Can be in inches. Other PTRD measurements B2 are also considered (eg, for 23, 25, and 27 gauge probes, with PTRD measurements B1 in the range of approximately 0.005 inches to 0.010 inches, angle Q2 is approximately 20). ~80 degrees). Other PTRD measurements B2 are also considered (eg, PTRD is in the range of approximately 0.003 to 0.015 inches, approximately 0.003 to 0.0085 inches for angle Q2, which is in the range of approximately 20 to 80 degrees). , About 0.005 to 0.025 inches, or about 0.008 to 0.010 inches). In some embodiments, an angle Q2 of approximately 60 degrees can result in a probe PTTD that is approximately equal to PTRD.

14a-c show some measurements for outer cutting tube 152 and inner cutting tube 154b of a vitrectomy probe, according to various embodiments. The outer port side opening 168 may have an approximate diameter OPDP1 of 0.015 inches. Other diameters are also contemplated (eg, in the range of approximately 0.009 to 0.02 inches, or in the range of approximately 0.013 to 0.017 inches). The port opening 168 can be circular, oval, or some other shape. The outer port opening depth OPD1 may be approximately 0.0045 inches. Other outer port opening depths OPD1 are also contemplated (eg, in the range of approximately 0.0027 to 0.063 inches, or in the range of approximately 0.0038 to 0.0052 inches). The outer port radius OPR1 may be approximately 0.008 inches. Other outer port radii OPR1 are also contemplated (eg, in the range of approximately 0.0048 to 0.0112 inches, or in the range of approximately 0.0068 to 0.0092 inches). The proximal port edge angle Pα1 may be approximately 50 degrees. Other proximal port edge angles Pα1 are also contemplated (eg, in the range of approximately 30-70 degrees, or in the range of approximately 40-60 degrees). The inner diameter ID1 of the outer cutting tube 152 may be approximately 0.0131 inches. Other inner diameters ID1 are also contemplated (eg, in the range of approximately 0.0079 to 0.018 inches, or in the range of approximately 0.011 to 0.015 inches). The outer diameter OD1 of the outer cutting tube 152 may be approximately 0.0165 inches. Other outer diameters OD1 are also contemplated (eg, in the range of approximately 0.010 to 0.023 inches, or in the range of approximately 0.014 to 0.019 inches).

As shown in FIG. 14b, the port depth D3 of the distal port 172 of the inner cutting tube 154b may be approximately 0.004 inches. Other port depths D3 are also contemplated (eg, in the range of approximately 0.0024 to 0.0056 inches, or in the range of approximately 0.034 to 0.0046 inches). The inner cutter inner diameter IOD1 of the inner cutting tube 154b is approximately 0.0127 inches and the first cutting edge 157 can flare up to 0.0130 inches. Other inner cutter inner diameter IOD1 are also contemplated (eg, in the range of approximately 0.0076 to 0.018 inches, or in the range of approximately 0.011 to 0.015 inches). Other flared spreads to the first cutting edge 157 are also contemplated (eg, in the range of approximately 0.0078 to 0.02 inches, or in the range of approximately 0.010 to 0.014 inches). The inner tube distal port to edge measurement G1 may be approximately 0.005 inches. In another embodiment, the inner tube port to edge measurement G1 may be approximately 0.006 inches. Other inner port to edge measurements G1 are also possible (eg G1 is in the range of approximately 0.003 inches to 0.012 inches, or in the range of approximately 0.003 to 0.007 inches, or approximately 0). Can be in the range of 0.004 to 0.006 inches). The inner tube proximal port to edge measurement H1 may be approximately 0.0155 inches. Other inner tube proximal port to edge measurements H1 are also considered (eg, in the range of approximately 0.0093 to 0.022 inches, or in the range of approximately 0.013 to 0.018 inches). The inner port edge angle IPα1 may be approximately 50 degrees. Other port edge angles α1 are also considered (eg, in the range of approximately 30-70 degrees, or in the range of approximately 40-60 degrees). As shown in FIG. 14c, the inner cutting tube port width PW1 may be approximately 0.009 inches. Other inner cutting tube port widths PW1 are also contemplated (eg, in the range of approximately 0.0054 to 0.013 inches, or in the range of approximately 0.0077 to 0.011 inches).

15a-d show measurements for the outer cutting tube 152 and the inner cutting tube 154c of the vitrectomy probe 112 according to an inner tube embodiment having a flat edge feature 185. Dimensions not specified in Figures 15a-d may have the same values or range of values as those of their counterparts specified in Figures 14a-c. The port edge to distal probe tip (PTTD) measurement F2 may be approximately 0.0098 inches for 23, 25, and 27 gauge probes. Other PTTD measurements F2 are also considered. For example, the PTTD measurement F2 may be in the range of approximately 0.0058 to 0.0137 inches, approximately 0.0083 to 0.011 inches, approximately 0.003 to 0.015 inches, approximately 0.003 to 0. It may be in the range of 0.0085 inches, approximately 0.005-0.025 inches, or approximately 0.008-0.010 inches. The port opening 168 can be circular, oval, or some other shape. The proximal port edge angle OPα2 may be approximately 50 degrees. Other proximal port edge angles OPα1 are also contemplated (eg, in the range of approximately 30-70 degrees, or approximately 40-60 degrees). The distal port edge angle ODα2 may be approximately 45 degrees. Other proximal port edge angles ODα2 are also contemplated (eg, in the range of approximately 25-65 degrees, or in the range of approximately 35-55 degrees). The outer tube upper edge radius UER2 may be approximately 0.002 inches. Other outer tube upper edge radii UER2 are also contemplated (eg, in the range of approximately 0.0012 to 0.0028 degrees, or in the range of approximately 0.0017 to 0.0023 degrees). The thickness T2 of the distal outer tube wall may be approximately 0.0022 inches. Other thicknesses T2 are also contemplated (eg, in the range of approximately 0.0013 to 0.0031 degrees, or in the range of approximately 0.0018 to 0.0025 degrees). The outer tube diagonal distance J2 may be approximately 0.010 inches. Other outer tube diagonal distances J2 are also considered (eg, in the range of approximately 0.006 to 0.014 degrees, or in the range of approximately 0.0085 to 0.0115 degrees). Inner diameter ID2 of outer cutting tube 152 may be approximately 0.0131 inches. Other inner diameter ID2s are also contemplated (eg, in the range of approximately 0.0079 to 0.018 inches, or in the range of approximately 0.011 to 0.015 inches). The outer diameter OD2 of the outer cutting tube 152 may be approximately 0.0165 inches. Other outer diameters OD2 are also contemplated (eg, in the range of approximately 0.010 to 0.023 inches, or in the range of approximately 0.014 to 0.019 inches).

As shown in FIG. 15b, the inner tube proximal port to edge measurement H2 may be approximately 0.0138 inches. Other inner tube proximal port to edge measurements H2 are also considered (eg, in the range of approximately 0.0083-0.019 inches, or in the range of 0.012-0.016 inches). The inner tube distal port to edge measurement G2 may be approximately 0.0047 inches. Other inner port to edge measurements G2 are possible (eg, G2 may be in the range of approximately 0.0028 inches to 0.0066 inches, or in the range of approximately 0.004 to 0.0055 inches). ). The port edge angle IPα2 may be approximately 50 degrees. Other port edge angles IPα2 are also considered (eg, in the range of approximately 30-70 degrees, or in the range of approximately 40-60 degrees). The outer port edge angle OPEα2 may be approximately 59 degrees. Other port edge angles OPEα2 are also considered (eg, in the range of approximately 35-85 degrees, or in the range of approximately 50-70 degrees). The depth ED1 of the inner tube flat edge feature 185 may be approximately 0.002 inches. Other depths ED1 are also contemplated (eg, in the range of approximately 0.0012 to 0.0028 inches, or in the range of approximately 0.0017 to 0.0023 inches). Inner port depth IPD1 may be approximately 0.004 inches. Other inner port depths IPD1 are also contemplated (eg, in the range of approximately 0.0024 to 0.0056 inches, or in the range of approximately 0.0034 to 0.0046 inches). The radius IPR2 of the proximal edge of the inner port may be approximately 0.00205 inches. Other proximal edge radii IPR2 are also contemplated (eg, in the range of approximately 0.00123 to 0.0287 inches, or in the range of approximately 0.00174 to 0.00236 inches). The inner tube inner diameter IND2 may be approximately 0.0096 inches. Other inner tube inner diameters IND2 are also contemplated (eg, in the range of approximately 0.0058 to 0.013 inches, or in the range of approximately 0.0082 to 0.011 inches). The outer diameter IOD2 of the inner tube of outer cutting tube 152 may be approximately 0.0122 inches. Other outer diameter IOD2 are also contemplated (eg, in the range of approximately 0.0073 to 0.017 inches, or in the range of approximately 0.010 to 0.014 inches).

FIG. 15c shows the inner cutting tube 154c and the outer cutting tube 152 at a point during the cutting cycle when the edge offset OFF1 is approximately 0 inches. Figure 15d shows inner cutting tube 154c and outer cutting tube 152 at an edge offset OFF2 of approximately 0.0043 inches during the cutting cycle. With an edge offset OFF1 of approximately 0 inches, the clearance DEC1 of the distal edge between the distal edge of the inner tube 154c and the distal inner surface of the outer tube 152 may be approximately 0.0084 inches. Other distal edge clearances DEC1 are also considered (eg, in the range of approximately 0.0050 to 0.012 inches, or in the range of approximately 0.0071 to 0.0097 inches). At an edge offset OFF2 of approximately 0.0043 inches, the distal edge clearance DEC2 between the distal edge of the inner tube 154c and the distal inner surface of the outer tube 152 may be approximately 0.0041 inches. Other distal edge clearances DEC2 are also considered (eg, in the range of approximately 0.0025 to 0.0057 inches, or in the range of approximately 0.0035 to 0.0047 inches). As further shown in FIG. 15c, the tube clearance C1 between the inner tube 154c and the outer tube 152 may be approximately 0.0005 inches. Other tube clearances C1 are also considered (eg, in the range of approximately 0.0003-0.0007 inches, or in the range of 0.00042-0.00058 inches).

As shown in FIGS. 16a-d, in some embodiments, the measurement F1 from the port to the distal probe tip may be in the range of approximately 0.003-0.012 inches. As another example, F1 is in the range of approximately 0.001-0.015 inches, approximately 0.003-0.015 inches, approximately 0.003-0.0085 inches, approximately 0.005-0. It may be in the range of .025 inches, or approximately in the range of 0.008 to 0.010 inches. In some embodiments, bevel angles BA1 and BA2 may be in the range of approximately 15-75 degrees. As another example, bevel angles BA1 and BA2 may be in the range of approximately 5 to 90 degrees. In some embodiments, G1 can be approximately 0.006 inches. Other G1 measurements are also considered (eg, in the range of approximately 0.0035 to 0.0085 inches, or in the range of approximately 0.005 to 0.007 inches). As shown in FIGS. 16c-d, embodiments of the inner cutting tube 154 are perpendicular to the inner tube longitudinal axis 194 at the portion of the inner cutting tube 154 that intersects the outer port side opening 168 (ie, for example, An upper flat edge 185 may be included (ranging from approximately 70 to 110 degrees). Other angles for the upper flat edge are also considered. In some embodiments, the upper flat edge 185 causes the inner cutting tube 154 to catch on the outer cutting tube 152 as the inner cutting tube 154 shears back and forth across the outer port side opening 168, or “ It can reduce the chances of being overwhelmed. As shown in FIGS. 16c-d, the distal portion of the inner cutting tube 154 may include flared edges. In some embodiments, inner cutting tube 154 may not be flared.

FIG. 17 is a partial cross-sectional view of a stepped air drive line that may be used with surgical console 100 to drive vitrectomy probe 112. As shown, surgical console 100 and vitrectomy probe 112 may be coupled to stepped air drive lines 402 and 404 (which may be used in place of pneumatic tubes 1002a-b). Stepped air drive lines 402 and 404 may be used within system 100 to drive vitrectomy probe 112.

The stepped air drive line 402 is described below. The features described with respect to stepped air drive line 402 may be present in stepped air drive line 404, and are equally applicable. As such, like reference numerals are used in FIG. 17 to identify like features for the stepped air drive lines 402 and 404.

Also, while FIG. 17 shows two separate step air drive lines 402 and 404 that provide the driving force to the vitrectomy probe 112, other embodiments include a single step air drive line or more than two. Use the stepped air drive line. Therefore, the limitation of the number of stepped pneumatic drive lines for providing the driving force to the vitrectomy probe 112 is not implied herein.

The stepped air drive line 402 may have a first segment 406 and a second segment 408. The first segment 406 has a proximal end 410 that is coupled to the surgical console 100 via the console port and a distal end 412 that is coupled to the second segment 406 via a sleeve 414 or a coupler. Can have. Further, the first segment may include an internal bore 416, or passageway, extending from the proximal end 410 to the distal end 412 of the first segment 406.

Although sleeve 414 is shown joining first segment 406 and second segment 408, it is contemplated that any other means may be used to join the two segments. For example, in other embodiments, one of the segments may be configured to slide into the other segment, thereby joining the segments without using sleeve 414. Moreover, in other embodiments, the air drive line 402 may be manufactured as a continuous drive line having two or more segments in a stepped configuration. In such an embodiment, the air drive line may not require a sleeve to join the segments. This is because the segments are made in a continuous drive line with a stepped configuration.

As shown, the first segment 406 can have an outer diameter OD1 that is substantially constant from the proximal end 410 to the distal end 412 of the first segment 406. By way of example, and not limitation, OD1 may be about 0.250 inch. Further, OD1 may be in the range of about 0.15 inch to about 0.5 inch. However, other dimensions of OD1 are considered, so that no implied limitations are set forth herein.

Further, the inner bore 416 of the first segment 406 can have a substantially constant inner diameter ID1 extending from the proximal end 410 to the distal end 412 of the first segment 406. By way of example, and not limitation, ID1 may be approximately 0.150 inches. Further, ID1 may be in the range of about 0.1 inches to about 0.3 inches. However, other dimensions of ID1 are considered, so that no implicit limitation is set forth herein.

The second segment 408 may have a proximal end 418 coupled to the first segment 406 via a sleeve 414 and a distal end 420 coupled to the vitrectomy probe 112. Further, the second segment 408 may include an internal bore 422 or passageway extending from the proximal end 418 to the distal end 420 of the second segment 408.

As shown, the second segment 408 may have a substantially constant outer diameter OD2 from the proximal end 418 to the distal end 420 of the second segment 408. By way of example, and not limitation, OD2 may be about 0.125 inches. Further, the OD2 may be in the range of about 0.05 inch to about 0.20 inch. However, other dimensions of OD2 are considered, so no implied limitation is set forth herein.

Further, the inner bore 422 of the second segment 408 may have a substantially constant inner diameter ID2 extending from the proximal end 418 of the second segment 408 to the distal end 420. By way of example, and not limitation, ID2 may be approximately 0.06 inches. Further, ID2 may range from about 0.01 inch to about 0.150 inch. However, other dimensions of ID2 are considered, so no implied limitation is set forth herein.

Therefore, the second segment 408 may be “stepped down” with respect to the first segment 406. In that regard, the outer diameter OD1 of the first segment 406 may be greater than the outer diameter OD2 of the second segment 408. Further, the inner diameter ID1 of the first segment 406 may be greater than the inner diameter ID2 of the second segment 408. Therefore, the second segment 408 can be "stepped down" from the first segment 406 so that when the air drive line extends from the surgical console 100 to the vitrectomy probe 112, it passes through the stepped air drive line 402. The extending passages may have non-uniform cross-sections and/or diameters. Although two segments are shown, in some embodiments any number of segments may be used (eg, 3, 4, 5, etc.). In some embodiments, the segment may have a larger inner diameter near the console 100. In some embodiments, the outer diameter may also vary from segment to segment (eg, increase in near segments of the console) (or remain the same).

Based on this stepped configuration, the stepped pneumatic drive line 402 may enhance the performance of the vitrectomy probe 112 as compared to other pneumatic instruments that use traditional pneumatic drive line tubes. As mentioned above, traditional air driven line tubes may have a constant inner diameter along the length of the tube. Therefore, the size of the passageway within the tube may remain the same as the pressurized gas travels from the surgical console to the surgical instrument.

In contrast, stepped air drive line 402 may have a non-uniform or non-uniform inner diameter (or cross-section) along the length of the drive line. By using a non-constant inner diameter, the stepped air drive line 402 can be optimized based on its functional needs along its length. The stepped air drive line 402 is closed at its end that is coupled to the vitrectomy probe 112 and may be considered to be driven from the end of the line that is coupled to the console 100, thus The driven end of the entrained air drive line 402 may have higher gas flow requirements. Therefore, in order to optimize gas flow, the driven end of the stepped air drive line 402 may have a larger diameter than the closed end.

Here, the first segment 406 may have an inner diameter ID1 in the inner hole 416 that is larger than the inner diameter ID2 of the inner hole 422 of the segment 408. As such, the internal holes 416 allow a larger amount of pressurized gas to be admitted to the line from the console 100, where a large flow of compressed gas is provided to optimize pneumatic performance. Most important.

Further, as mentioned above, the use of a non-constant inner diameter allows the stepped air drive line 402 to be optimized based on its functional needs along its length. In that regard, because the traditional pneumatic drive line has a constant diameter, the portion of the drive line adjacent the vitrectomy probe 112 is required at the other end being driven by the surgical console 100. It may have the same large inner diameter as that done. As such, the tube may have more than ideal size and mass, so that the tube may generally be less flexible than desired near the vitrectomy probe 112. There is a nature.

The stepped air drive line 402 may address this issue. As mentioned above, the stepped air drive line 402 may include a second segment 408 having an inner diameter ID2 and an outer diameter OD2 that are smaller than the inner diameter ID1 and the outer diameter OD1 of the segment 406. As such, the stepped air drive line 402 may provide a narrower drive line (eg, the second segment 408) adjacent the vitrectomy probe 112, where it is more flexible and less flexible. Mass is important to the user of the vitrectomy probe 112. In some embodiments, the stepped air drive line may include a larger diameter in the air line segment closer to the surgical console 100, while having a diameter step-down (eg, via a connector), 12 inches (close to the vitrectomy probe 112) will have an outer diameter of approximately 0.125 inches and an inner diameter of 0.06 inches (the last segment of other lengths (eg, longer or shorter than 12 inches). ) And other diameters are also considered). Therefore, the tubing of the stepped air drive line 402 optimizes pneumatic performance by having a larger diameter near the console 100, while providing greater flexibility and lower mass near the vitrectomy probe 112. Can be configured to provide.

FIG. 18 shows a partial cross-sectional view of sleeve 414 coupling distal end 412 of first segment 406 to proximal end 418 of second segment 408. As shown, the sleeve 414 may have a proximal hole 502, a connecting hole 504 or intermediate hole, and a distal hole 506. Proximal hole 502 can be sized and shaped to receive the distal end 412 of first segment 406.

Further, the proximal bore 502 is defined in part by the inner surface 508 of the sleeve 414. In that regard, the inner surface 508 may be tapered or beveled toward the connection hole 504. As a result, the distal end 412 of the first segment 406 can be coupled to the sleeve 414 by a press fit or sealing engagement with the tapered inner surface 508 that exerts a coupling force on the distal end 412.

Additionally, the proximal hole 502 can include a stop 510. The stop 510 may prevent the distal end 412 from extending into the connection hole 504. In that regard, the distal end 412 of the first segment 406 may abut the stop 510 when fully inserted into the sleeve 414. Therefore, the stop 510 may prevent over-insertion of the distal end 412 into the sleeve 414.

Distal hole 506 can be sized and shaped to receive proximal end 418 of second segment 408. Distal hole 506 may be defined in part by inner surface 516 of sleeve 414. In that regard, the inner surface 516 may be tapered or beveled toward the connection hole 504. As a result, the proximal end 418 of the second segment 408 may be coupled to the sleeve by a press fit or sealing engagement with a tapered inner surface that exerts a coupling force on the proximal end 418.

Further, the distal bore 506 can include a stop 518. The stop 518 may prevent the proximal end 418 from extending into the connection hole 504. In that regard, the proximal end 418 of the second segment 408 may abut the stop 518 when fully inserted into the sleeve 414. Therefore, the stop 518 may prevent overinsertion of the proximal end 418 into the sleeve 414.

As shown, the connection hole 504 may be positioned between the proximal hole 502 and the distal hole 506. The connection hole may have a conical shape. In that regard, the inner surface 520 defines a connection hole 504 and may taper toward the distal hole 506. As such, the opening 512 of the connection hole 504 adjacent the proximal hole 502 may have a larger diameter than the opening 514 adjacent the distal hole 506. Further, the opening 512 may have a diameter substantially similar to the inner diameter ID1 of the inner hole 416 of the first segment 406. Further, the opening 514 can have a diameter substantially similar to the inner diameter ID2 of the inner bore 422 of the second segment 408. Due to the dimensions of the openings 512 and 514, and the conical shape of the connection hole 504, a seal may be formed between the inner hole 416 of the first segment and the inner hole 422 of the second segment 408, which allows , Pressurized gas can flow therethrough.

Other tapered tubes are also contemplated. For example, the tapered pneumatic drive line is a continuous taper from the surgical console 100 to the vitrectomy probe 112. In other words, the outer surface of the air drive line and the inner surface defining the bore may both be continuous taper from the proximal end to the distal end of the tapered air drive line. In some embodiments, the inner surface may be tapered while the outer surface remains constant.

FIG. 19 shows a flowchart of a method for operating a vitrectomy probe, according to an embodiment. The elements provided in the flowchart are for illustration only. Various elements provided may be omitted, additional elements may be added, and/or various elements may be implemented in a different order than that provided below.

At 1901, a trocar cannula can be inserted into the eye. In some embodiments, the trocar cannula can be inserted into an area of the eye that allows instruments inserted through the trocar cannula to access the vitreous and retina.

At 1903, a vitrectomy probe can be inserted through the trocar cannula and into the eye.

At 1905, the vitrectomy probe can be activated, and the vitreous entering a port at the vitrectomy probe can be removed by aspiration from the vitrectomy probe.

At 1907, the vitrectomy probe can be removed from the cannula.

Various modifications may be made to the presented embodiments by those skilled in the art. Other embodiments of the invention will be apparent to those skilled in the art from consideration of this specification and practice of the invention disclosed herein. It is intended that the specification and examples be illustrative only, with the true scope and spirit of the invention being indicated by the following claims and their equivalents.

Claims (20)

Outer cutting tube with outer port side opening;
An inner cutting tube positioned within the outer cutting tube, the inner cutting tube having an open distal end having a cutting edge;
The inner cutting tube further includes a distal side port, a distal side port cutting edge positioned on the distal side port, and when the inner cutting tube is retracted into the outer cutting tube. Tissue contained in the outer port side opening also enters the distal side port of the inner cutting tube and is cut by the distal side port cutting edge as the inner cutting tube is retracted into the outer cutting tube. Inner cutting tube;
A diaphragm coupled to the inner cutting tube, wherein the diaphragm is located in a driving chamber, and the diaphragm is configured such that when air is alternately supplied and vented on both sides of the diaphragm in the driving chamber, A diaphragm configured to move back and forth in the drive chamber;
A vitrectomy probe, including:
Movement of the diaphragm causes the open distal end of the inner cutting tube to move back and forth across the outer port side opening to cut tissue contained in the outer port side opening. Vibrating the inner cutting tube in the outer cutting tube;
The diaphragm includes an open stroke side surface having a first contact surface for contacting the inner wall of the drive chamber when the inner cutting tube is in the retracted position;
The diaphragm includes a closed stroke side surface having a second contact surface for contacting an opposing drive chamber wall when the inner cutting tube is in the extended position; and the first contact surface is the first contact surface. A vitrectomy probe comprising a material having a lower hardness than the two contact surfaces. The vitrectomy probe of claim 1, wherein the first contact surface comprises silicone and the second contact surface comprises polycarbonate or polysulfone. The outer cutting tube has a beveled closed end and the degree of beveling is measured from the beveled closed end to an extended rear line of the outer cutting tube opposite the outer port side opening. The vitrectomy probe of claim 1, sometimes in the range of approximately 20-80 degrees. The distance from the port edge tip to the retina (PTRD) is in the range of approximately 0.004 to 0.009 inches, and the measurement from the port edge to the distal probe tip (PTTD) is approximately 0.005 to 0. A bevel of approximately 60 degrees when measured from the beveled closed end to the extended rear line of the outer cutting tube opposite the outer port side opening in the range of .010 inches. Item 3. The vitrectomy probe according to Item 3. Further included is a first suction tube rigid tube including a suction tube coupled to the inner cutting tube for evacuating the inner cutting tube, and the suction tube configured to be coupled to a surgical console. A first suction tube and a second suction tube coupled to the first suction tube and the vitrectomy probe, wherein the second suction tube has a hardness of the first suction tube. The vitrectomy probe of claim 1, having a second suction tube hardness of less than. The first suction tube has an inner diameter of approximately 0.060 inches, and the first suction tube hardness of approximately 80 Shore A, and the second suction tube has an inner diameter of approximately 0.060 inches. , And having the second suction tube hardness of approximately 40 Shore A;
The first suction tube is approximately 79 inches in length, and the second suction tube is approximately 5 inches in length, and is coupled at the distal end to the vitrectomy probe, and The vitrectomy probe of claim 5 coupled to the first suction tube at a proximal end. 2. The vitrectomy according to claim 1, wherein the outer port side opening has a proximal port edge angle in the range of approximately 40-60 degrees and a distal port edge angle in the range of approximately 35-55 degrees. probe. Further, including an air drive line coupling the vitrectomy probe to a surgical console, the air drive line having an internal hole configured to deliver the air to the vitrectomy probe, the internal drive line comprising: The hole has a non-uniform cross-section along the length of the air drive line, the air drive line including a first segment and a second segment, the first segment having a first diameter. Defining a first passage having a second diameter having a second diameter and the second segment defining a second passage having a second diameter, the first segment being different from the second diameter. Item 2. The vitrectomy probe according to Item 1. Outer cutting tube with outer port side opening and beveled closed end;
An inner cutting tube positioned within the outer cutting tube, the inner cutting tube having an open distal end having a cutting edge and a distal side port having a distal side port cutting edge, A distal side port cutting edge is positioned at the distal side port so that when the inner cutting tube is retracted into the outer cutting tube, the tissue contained in the outer port side opening is also distal to the inner cutting tube. An inner cutting tube that enters a side port to cause the inner cutting tube to be cut by the distal side port cutting edge when retracted into the outer cutting tube;
A diaphragm coupled to the inner cutting tube, wherein the diaphragm is located in a driving chamber, and the diaphragm is configured such that when air is alternately supplied and vented on both sides of the diaphragm in the driving chamber, Diaphragm configured to move back and forth in the drive chamber;
A vitrectomy probe, including:
Movement of the diaphragm causes the open distal end of the inner cutting tube to move back and forth across the outer port side opening to cut tissue contained in the outer port side opening. Vibrating an inner cutting tube within the outer cutting tube; and the inner cutting tube at a portion of the inner cutting tube that cuts across the outer port side opening, an upper flat substantially perpendicular to the inner tube longitudinal axis. Vitrectomy probe, including edges. 10. The vitrectomy according to claim 9, wherein the outer port side opening has a proximal port edge angle in the range of approximately 40-60 degrees and a distal port edge angle in the range of approximately 35-55 degrees. probe. Movement of the diaphragm causes the open distal end of the inner cutting tube to move back and forth across the outer port side opening to cut tissue contained in the outer port side opening. Vibrating the inner cutting tube in the outer cutting tube;
The diaphragm includes an open stroke side surface having a first contact surface for contacting a drive chamber inner wall when the inner cutting tube is in the retracted position;
The diaphragm includes a closed stroke side surface having a second contact surface for contacting an opposing drive chamber inner wall when the inner cutting tube is in the extended position; and the first contact surface is the first contact surface. 10. The vitrectomy probe of claim 9, comprising a material having a lower hardness than the two contact surfaces. Further included is a suction tube coupled to the inner cutting tube for evacuating the inner cutting tube; and the suction tube is configured to be coupled to a surgical console, and a first suction tube rigid. A first suction tube and a second suction tube coupled to the first suction tube and the vitrectomy probe, wherein the second suction tube has a hardness of the first suction tube. 10. The vitrectomy probe of claim 9, having a second suction tube hardness below. The first suction tube has an inner diameter of approximately 0.060 inches, and the first suction tube hardness of approximately 80 Shore A, and the second suction tube has an inner diameter of approximately 0.060 inches. , And having a second suction tube hardness of approximately 40 Shore A; and the first suction tube is approximately 79 inches in length, and the second suction tube is approximately 5 in length. 13. The vitrectomy probe of claim 12, which is inch and is coupled at the distal end to the vitrectomy probe and at the proximal end to the first aspiration tube. Further, including an air drive line coupling the vitrectomy probe to a surgical console, the air drive line having an internal hole configured to deliver the air to the vitrectomy probe, the internal drive line comprising: The hole has a non-uniform cross-section along the length of the air drive line, the air drive line including a first segment and a second segment, the first segment having a first diameter. Defining a first passage having a second diameter having a second diameter and the second segment defining a second passage having a second diameter, the first segment being different from the second diameter. Item 10. The vitrectomy probe according to Item 9. The port edge tip to retina (PTRD) distance for the outer port side opening is in the range of approximately 0.004 to 0.009 inches, and the port edge for the outer port side opening to the distal probe tip. (PTTD) is in the range of approximately 0.005 to 0.010 inches from the beveled closed end to the extended rear line of the outer cutting tube opposite the outer port side opening. 10. The vitrectomy probe of claim 9, which has a bevel of approximately 60 degrees when measured. Outer cutting tube with outer port side opening;
A vitrectomy probe including an inner cutting tube positioned within the outer cutting tube, the inner cutting tube having an open distal end having a cutting edge,
The inner cutting tube further includes a distal side port with a distal side port cutting edge positioned at the distal side port to cause the inner cutting tube to cut the outer cutting port. When retracted into a tube, the tissue contained in the outer port side opening also enters the distal side port of the inner cutting tube and the distal side port when the inner cutting tube is retracted into the outer cutting tube. To be cut by a cutting blade;
The outer cutting tube has a beveled closed end, and the distance from the port edge tip to the retina (PTRD) is in the range of approximately 0.004 to 0.009 inches, and relates to the outer port lateral opening. A measurement from the port edge to the distal probe tip (PTTD) is in the range of approximately 0.005-0.010 inches, and from the beveled closed end to the outer cut facing the outer port side opening. Vitrectomy probe, which is a bevel of approximately 60 degrees when measured to the extended posterior line of the tube. Further included is a first suction tube rigid tube including a suction tube coupled to the inner cutting tube for evacuating the inner cutting tube, and the suction tube configured to be coupled to a surgical console. A first suction tube and a second suction tube coupled to the first suction tube and the vitrectomy probe, wherein the second suction tube has a hardness of the first suction tube. 18. The vitrectomy probe of claim 16, having a second suction tube hardness of less than. Further, including an air drive line coupling the vitrectomy probe to a surgical console, the air drive line having an internal hole configured to deliver the air to the vitrectomy probe, the internal drive line comprising: The hole has a non-uniform cross-section along the length of the air drive line, the air drive line including a first segment and a second segment, the first segment having a first diameter. Defining a first passage having a second diameter having a second diameter and the second segment defining a second passage having a second diameter, the first segment being different from the second diameter. Item 16. The vitrectomy probe according to Item 16. The outer cutting tube has a beveled closed end, and the inner cutting tube is substantially perpendicular to the inner tube longitudinal axis at the portion of the inner cutting tube that cuts across the outer port side opening. 17. The vitrectomy probe of claim 16 including an upper flat edge. The first suction tube has an inner diameter of approximately 0.060 inches, and the first suction tube hardness of approximately 80 Shore A, and the second suction tube has an inner diameter of approximately 0.060 inches. , And having a second suction tube hardness of approximately 40 Shore A; and the first suction tube is approximately 79 inches in length, and the second suction tube is approximately 5 in length. 17. The vitrectomy probe of claim 16, which is inch and is coupled at the distal end to the vitrectomy probe and at the proximal end to the first suction tube.

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